Overall, minorities suffer a significantly higher burden of morbidity and mortality compared to whites, despite improvement of the nation's health in general over the past few decades. Across the nation, African Americans have an infant mortality rate more than twice the rate for whites. Statistics for Virginia reflect the National data. In Richmond, Virginia, African Americans suffer a disproportionate amount of adverse pregnancy outcomes, with an infant mortality rate ranging from 2 to 4 times the rate for whites from 2000- 2004. In an effort to improve pregnancy outcomes for African Americans in the Richmond area, the Virginia Commonwealth University (VCU) Center of Excellence in Health Disparities Research (CoEHDR) proposes to (1) conduct research on adverse pregnancy outcomes in African Americans, (2) stimulate new research in this area, (3) work with community stakeholders to conduct and evaluate the impact of a community health education intervention, (4) promote participation of minority populations in research (5) incorporate a research training component for minority students into community engagement/outreach efforts. To accomplish these aims, the CoEHDR will engage in the following activities. The CoEHDR will initiate three full research projects and two pilot projects in the first year of funding. Full research projects will focus on the genetics of preterm birth in African Americans, immunological responses to periodontis that may lead to premature birth, and increasing Safer Sex Skills development among pregnant women at high risk for HIV infection. Pilot projects will involve enhancing fetal exposure to antiretroviral medications and describing the geographic distribution of birth outcomes and environmental stressors. All research will focus on African American subjects, with the goals of identifying and implementing unique diagnostic and interventions that will address major health disparities. As the research pillar of VCU's Center on Health Disparities (CHD), the CoEHDR will capitalize on CHD infrastructure to stimulate research in health disparities at VCU, identifying researchers who can focus their efforts in this vital area. In addition, the CoEHDR will work with community stakeholders to conduct and evaluate the impact of a community health education intervention on healthier pregnancies. The CoEHDR will also provide research training opportunities for disparity population students, who will work with investigators on the health education intervention and other research projects.